DOI: 10.4103/jiaomr.jiaomr_150_26 ISSN: 0972-1363

Comparative Evaluation of Fractal Dimension and Lacunarity of Mandibular Bone in Tobacco Users and Nonusers using Digital Panoramic Radiographs—An Observational Study

Ramesh K. Koothati, Nidadavole Shrijitha, K. J. Jalin, Abhishek Gupta, Chilaka Thabitha, Haritha Selvaraj
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Abstract

Background:

Digital orthopantomograms enable noninvasive assessment of tobacco-associated trabecular bone alterations using fractal dimension and lacunarity of mandible.

Objective:

To evaluate mandibular trabecular bone fractal dimension and lacunarity in smokers, smokeless tobacco users, and nonusers using panoramic radiographs.

Methods:

This cross-sectional study included 90 subjects equally divided into smokers, smokeless tobacco users, and controls. Bilateral regions of interest were analyzed using ImageJ software with the FracLac plugin. Intergroup comparisons were performed using ANCOVA with age adjustment, while correlation and regression analyses assessed associations with tobacco exposure.

Results:

Age-adjusted mean FD was significantly lower in smokers (1.165 ± 0.009) and smokeless tobacco users (1.168 ± 0.009) than controls (1.205 ± 0.009) ( P = 0.012), whereas lacunarity was significantly higher (0.309 ± 0.015, 0.317 ± 0.015, and 0.287 ± 0.015, respectively; P = 0.022). Correlation analyses showed trends toward trabecular deterioration with increasing tobacco exposure, although most associations were not significant. Age-adjusted regression identified tobacco frequency and duration as significant predictors of reduced FD and increased lacunarity ( P < 0.05).

Conclusion:

Fractal dimension and lacunarity analysis may serve as adjunctive indicators of tobacco-associated mandibular trabecular alterations. Further longitudinal studies are needed before their utility as screening tools can be established.

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